April 15, 2010

The future of the NHS and service provision formed a central part of this evenings national election debate from Manchester screened live on ITV with concurrent audio on BBC Radio 4. Health care as expected did play an important role this evening. Here are a few quotes from the chief protagonists, Brown and Cameron:

Gordon Brown on the leader of the opposition, and on health care in general.

He [Cameron] couldn't give the same personal guarantees that we're giving about specialist cancer care

Fair to our National Health Service

Protect our helath service

David Cameron: rhetoric, with some serious points.

Choose hope over fear

Stop labours 'job tax' which could destroy our economy

If you work had 'll be behind you

If you're old and you become ill we will always be there for you.

Gordon Brown attacked the leader of the opposition about their plans and possible changes to the two week wait.But what is this two week wait? If you work as a doctor in the NHS, you'll already know, but for those that may not be so well informed, what does the two week wait actually mean in practice?

Essentially the 2WW (as its popular abbreviation) is the target that a patient with suspected cancer should be seen within two weeks of the referral being received. A good system? It seems so. Actually the targets go further, with the first 'definitive treatment' being delivered within the first 62 days from referral. This essentially means if you need an operation to have your cancer out, it is the responsibility of the doctors to diagnose it and treat it definitively. This means the necessary scans, biopsies pre-op checks and the like to achieve things. Lots of NHS initiatives have been criticised. The four hour wait has long been criticised by doctors (including this one) in Accident and Emergency departments, however it does seem to have driven up standards and efficiency in our hospitals. In principle, the two week wait is a good thing. So why would it be cut by the conservatives?

The answer is complex, and not explained in the media writ large. There has been much focus on labours mailshot to potential cancer sufferers, but what politician in their right mind would cut such progress? (Guardian coverage here). The answer lies in policy and procedure, and represents why health is such a sensitive topic. ON the basis of Browns comments above, who without health insurance would not vote Labour? Unless the plans are presented clearly and simply (tonight they were not) it is difficult for those even inside healthcare to make informed voting decisions on such issues.

The conservative leader did consistently focus on the fact that Labour has had 13 years to fix things: how is Labour currently planning to fix things? By saving money, lets look at if its going to hit the workers in the health service (me) or the patients (me). Are there tough choices that have really been outlined for the NHS to date in terms of cuts?

Efficiency Savings: What is the level of 'pain' the NHS can expect?

These points come from the Department of Healths own press release here: I cant help but provide my own bottom line opinion for what it means to staff and patients.

The Department of Health and the NHS will meet this target through a range of activities including:

"Up to £1.5bn will be saved by driving down the costs of procurement through securing best prices for goods and services"

The bottom line: no pain for the workers or the patients

"£100m will be saved by taking a new approach to the National Programme for IT that offers greater choice to local hospitals"

The bottom line: no pain for the workers or the patients (unless you're in IT!)

"£60m will be saved by reducing the amount of energy the NHS uses, to deliver a 10 per cent cut in carbon emissions"

No pain for the workers or the patients, lots of energy saving light bulbs on the shopping list

"Up to £70m will be saved from more efficient use of NHS estates"

No pain for the workers or the patients, don't expect to buy the local hydrotherapy pool at a cut price

"Up to £555m by reducing staff sickness absence in the NHS."

No pain for the workers or the patients, unless you're doing things you shouldn't be.

Andy Burnham the health secretary had the following to say on the 4.5billion saved in the budget.

The NHS budget is in a strong position after a decade of record investment. I am pleased that today’s Budget locks in that growth, guaranteeing that frontline NHS funding will rise with inflation in 2011-12 and 2012-13. As a result of this funding, the NHS is today more resilient, has more capacity and provides better care than ever before.

Healthcare, two week waits, cancer services, provision of care for the elderly, the payment of this care, and taxation of those receiving it will continue to play a key part in the election leading up to May 2010. As you can see how these policies, and changes to current policy are presented is likely to influence the publics next choice of government.

Missed it? You can catch up on ITV here on what went on. Id be interested to hear comments from anyone and everyone on the above musings...